The interview: with Sarojini Nadimpally - women’s health, Covid-19, and inequalities

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The interview: with Sarojini Nadimpally - women’s health, Covid-19, and inequalities.

Sarojini Nadimpally is a Public health researcher and social scientist. She helped to start Sama in Delhi. Sama means ‘equality’ in Sanskrit. Sama works with public health and women’s movements. She was organizing deliveries of PPE to frontline workers and now she speaks to Amy Hall about women’s health, Covid-19, and the inequalities Covid-19 made worse.


How have Covid-19 and the lockdown affected Sama’s work?

SN: It hasn’t been easy. There was no warning about the lockdown. It affected everyone, particularly the poor, migrants, and people who need day-to-day work.

We have seen more social and economic problems. It is very important to look at the problems now of hunger, violence, and healthcare.

With Covid-19 we had to do more work remotely. Our work, particularly outside of Delhi, and with girls and women from marginalized communities, is difficult because of problems with communication. Sometimes there is no internet and not everyone has a smartphone. So it’s not easy. In India things are very different in the countryside. The men in the family often control mobile phones. So it is difficult for women, and particularly girls. Men control society. It’s not something new, but Covid-19 has made inequalities worse. But Sama has tried to help.

Early in the lockdown Sama took a case to the Delhi High Court to make sure that women could still get maternal health services. How did this come about?

SN: Again and again we found many maternal health problems. People were calling and saying, ‘Where do we go? How do we go?’ It was not easy because when you are a health group, people expect you to help. You feel helpless.

Pregnant women have big difficulties in finding maternal and reproductive health services. The Covid-19 lockdown means no transport and no care for women. Many women who need healthcare for safe births or for newborn babies are experiencing trauma in Delhi and in other parts of the country.

The court case was because of a young girl from a poor background. She spent nearly 48 hours trying to get emergency services for her pregnancy and birth. There were many examples like this. First we wrote to the government. And then we thought, no, we could stop these maternal deaths and we could get some help through the public-interest court case. These situations show what is really happening. The government gives advice on maternal and reproductive health services and it says they are essential services. But where are they?

What lessons do you think we need to learn from Covid-19?

SN: The problems we see need a political, social, and economic solution. These are not new problems. After Covid-19 it is likely things will go back to what they were before. This will need women’s movements to come together and say no to ‘business as usual’.

We need to think in a different way now. Authoritarianism, surveillance, discrimination – particularly against the Muslim community – are worse with Covid-19. We must stop them.

We must understand the experience of women. It depends on their caste, disability, where they live, age, and the work they do. A sanitary worker is very different from a doctor. Women are a big part of informal work – domestic workers, factory workers, those in the hospitality industry, and also sex workers. They have lost their jobs, and we need to look at the question of women’s rights as workers.

Most frontline health workers are women. They have found the biggest problems from Covid-19 with safe working conditions, not enough PPE, loss of jobs and money – especially in private healthcare.

Part of Sama’s work is with clinical trials. Have you been thinking about this with Covid-19?

SN: In the last two months we have been busy with the Covid-19crisis. There was no time to think about Covid-19 and a vaccine.

But a new vaccine must be safe, must work, and not be expensive. And the public systems need to have the organization give a vaccine at the right time to everyone who needs it and not stop giving other vaccines or other services.

The vaccine must have good clinical trials. I would ask, who’s sponsoring the trials? Who will be the first people to have tests? Who are the ethics committees who approve the trials? Who will take the responsibility for any serious problems during the trials? Will they pay the people who have the tests? If there is a vaccine, can the poor have it and will it be cheap enough? All the data should be clear and open.

With vaccines it is always a question of are you for it or against it. There is no other way people will look at it. We all had BCG [tuberculosis] and polio vaccines. If you question any vaccine, then people say you are against vaccines, and that is not correct.

A vaccine may take another couple of years, and it shouldn’t stop other public-health services. There is very little correct information. Action on Covid-19 is just as important. Things like testing and how we make sure that it’s fair – because in the private sector testing is very expensive.

What is one of the biggest problems in your work?

SN: Will our research work change policy? It’s not enough for me to write a paper. Will there be action?


(This article has been simplified so the words, text structure and quotes may have been changed)